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To develop and evaluate a CT-based radiomics nomogram for differentiating gastric neuroendocrine carcinomas (NECs) from gastric adenocarcinomas (ADCs). CT images of 63 patients with gastric NECs were collected retrospectively, and 63 patients with gastric ADCs were selected as the control group. Univariate analysis was used to identify the significant factors of clinical characteristics and CT findings for differentiating gastric NECs from ADCs. Radiomics analysis was applied to CT images of unenhanced, arterial phase and venous phase,